Provider Demographics
NPI:1811569718
Name:TESSINARI, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:TESSINARI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 STEEPLECHASE DR
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-1912
Mailing Address - Country:US
Mailing Address - Phone:551-206-7331
Mailing Address - Fax:
Practice Address - Street 1:39 STEEPLECHASE DR
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746-1912
Practice Address - Country:US
Practice Address - Phone:551-206-7331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJAG03210088363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner